This invention relates to an improved osteochondral autograft transplantation procedure and apparatus, and more particularly, to such a procedure and apparatus in which a graft is implanted in a recipient opening.
The human knee consists of three bones—a femur, a tibia, and a patella—that are held in place by various ligaments. The corresponding condyles of the femur and the tibia form a hinge joint, and the patella protects the joint. Portions of the condyles, as well as the underside of the patella, are covered with an articular cartilage, which allow the femur and the tibia to smoothly glide against each other without causing damage.
The articular cartilage often tears, usually due to traumatic injury or degenerative processes. This tearing does not heal well due to the lack of nerves, blood vessels and lymphatic systems; and the resultant knee pain, swelling, and limited motion of the bone(s) must be addressed.
Damaged adult cartilages have historically been treated by a variety of surgical interventions including lavage, arthroscopic debridement, and repair stimulation, all of which provide less than optimum results.
Another known treatment involves removal and replacement of the damaged cartilage with a prosthetic device. However, prostheses have largely been unsuccessful since they are deficient in the elastic, and therefore in the shock-absorbing, properties characteristic of the cartilage. Moreover, prostheses have not proven able to withstand the forces inherent to routine knee joint function.
In an attempt to overcome the problems associated with the above techniques, osteochondral autograft transplantation, also known as “mosaicplasty” has been used to repair articular cartilages. This procedure involves removing injured tissue from the damaged area and drilling one or more openings in the underlying bone. A graft, or plug, consisting of healthy cartilage overlying bone, is obtained from another area of the patient, typically from a lower weight-bearing region of the joint under repair, or from a donor patient, and is implanted in each opening. Although it is extremely important that each plug fit in its opening in a precise manner, this is difficult since it is often impossible to cut a graft the same size as the diameter of the defect. Although a series of grafts having a circular cross section could be cut and then placed in the defect, this would not be practical since voids or spaces would be present between the adjacent grafts.
Therefore, what is needed is a technique in which a series of grafts can be harvested and placed in a closely-spaced relationship in the defect with a minimum of spacing between the grafts. The present invention relates to such a technique.